Dr Kingsland: some consortia will be able to set their own priorities (Photograph: NTI)

The government has proposed making the payments to consortia that hit targets for improving patient outcomes and balancing their budgets.

BMA leaders have criticised the idea, saying GPs' income should not be based on their ability to save the NHS money.

But DoH national clinical commissioning network lead Dr James Kingsland said highly developed consortia will gradually be allowed to set their own priorities locally.

Dr Kingsland said the NHS Commissioning Board will manage implementation of the quality premium initially.

But he said once patients 'trusted' the new system, 'part of that incentive system should transfer to consortia'.

'As confidence grows, I think it's sensible that part of the incentive scheme transfers to GPs over time. There will of course be plenty of checks and balances,' he said.

Speculation that the quality premium would account for 10 to 15% of GP income was 'testing the water and starting the debate', he said. 'No final decision has been taken on a figure yet. It will be a low proportion of GP income, not a high one,' he added.

'For the majority of my colleagues, I think this will be quite insulting,' he said. 'Our profession is populated by dedicated, high achieving people. All of a sudden we're tarred by this idea that we'll only get out of bed for money.'

He said the Health Bill contained a 'massive array of regulations' to prevent GPs profiteering. 'Where consortia are making decisions about priorities in the quality premium, the NHS Commissioning Board will be making checks that they are appropriate,' he said.